Ashford, a Blue Dog Democrat with more moderate views on abortion, won the seat in 2014, despite that year’s Republican headwind, and party officials thought he was the best candidate to win it back this year (he lost it in 2016).

The outcome caught national operatives off guard. While they say it’s too soon to tell how the result will affect their plans, it seems likely the district will tumble down their priority list, if it doesn’t get removed entirely.

At the same time, progressives are anxious for the chance to prosecute their case that Democrats don’t have to run as centrists to win, even in places like Nebraska, especially in wave election year.

“Progressives want to prove this cycle that an inspiring economic agenda is how to win in red and purple districts, in addition to blue districts,” said Adam Green, the co-founder of the Progressive Change Campaign Committee, one of Eastman’s biggest supporters.

“We’re eager to prove that views like Medicare for All, higher wages for workers, and other economic populist ideas are the right way to win,” Green added.

Eastman’s nomination means the general election, against Rep. Don Bacon, R-Neb., is likely to be fought over Medicare for All, also known as single-payer health care.

“Kara Eastman showed the DCCC that far-left progressives are in full control of the party and they are just along for the ride,” said Jesse Hunt, a spokesperson for the National Congressional Campaign Committee. “Single-payer health care is Eastman’s most passionate issue and her values are a better fit for Nancy Pelosi’s San Francisco than Nebraska.”

While Medicare for All encompasses a wide range of ideas, Eastman has signed on to the more maximalist approach, a House bill that would cover all Americans with a more generous version of Medicare.

Moving towards a Canadian-style healthcare system has been a pipedream of the left for decades, but Democrats only began to take it seriously after President Donald Trump’s election.

That means the politics of the issue remain largely untested, even as it has seen a meteoric rise in acceptance among mainline Democrats.

Nebraska’s 2nd congressional district, which Barack Obama narrowly won in 2008 and Hillary Clinton narrowly lost in 2016, now offers that test. And Omaha, the district’s biggest city, is demographically fairly representative of the rest of the country.

This was not a fight so-called establishment Democrats wanted, however.

Supporters of Medicare for All are quick to point to polls suggesting the plan is popular, and say the party needs big ideas to get people to the polls. But more skeptical Democrats note the country has yet to seriously debate the issue.

That means Republicans haven’t yet spent millions of dollars highlighting the costs of government-run health care, which could run into the trillions.

The President of House Majority PAC, Democrats’ flagship congressional super PAC, argued on Twitter that while Medicare for All sounds nice, voters opinions are likely turn on a dime when they hear more.

But the one thing everyone agrees is that no one really knows for sure, because the issue has never really been litigated in a competitive election.

Now, whatever Omahans make of Medicare for All may have lasting reverberations for the future of the Democratic politics and, by extension, the future of healthcare in America.